Sexual Aspects of Pelvic Floor Disturbances/Disorders

Abstract

This chapter will pay attention to the disturbances related to the pelvic floor, focusing on their sexuality-related consequences. It will start with the troubles during pregnancy, followed by the problems after childbirth. At the end of each topic, it will offer treatment recommendations. The urinary disorders will cover stress urinary incontinence (SUI), urgency urinary incontinence (UUI), climacturia (losing urine during orgasm), and urinary tract infections. The defecation disorders will cover anal incontinence, flatal incontinence, and constipation. Pelvic organ prolapse (POP) does usually not happen in the first pregnancy, though the primigravid woman can have similar complaints. Pelvic girdle pain (PGP) tends to start during pregnancy. Pregnancy and vaginal birth are the most common risk factors for postpartum PF disorders: stress urinary incontinence, overactive bladder syndrome, pelvic organ prolapse, and anal incontinence. On the one hand, that may sound like pathologizing childbirth. On the other hand, healthcare providers should be aware that they tend to underestimate the rates of (anal) obstetric injuries, and most textbooks do not mention levator ani avulsion. Aspects of pelvic floor muscle training (PFMT) receive ample attention in the treatment recommendations. In the postpartum part, the chapter pays extra attention to perineal pain, vaginal laxity, and overactive pelvic floor. Those are disruptive elements for intimacy and sexuality, just like all the other mentioned disturbances. This chapter is part of ‘Midwifery and Sexuality’, a Springer Nature open-access textbook for midwives and related healthcare professionals.